ENDOSCOPE DECONTAMINATION UNITS
Making sure ventilation is effective and fit for purpose
In March 2021 – on behalf of the Central Sterilising Club – John Prendergast, MIHEEM, an Authorising Engineer (Decontamination), and Dr Jimmy Walker, Chair of the Central Sterilising Club, established, and have since led, a Working Group to review guidance for ventilation requirements in endoscope decontamination facilities. Here, with input from all the Group’s members, they discuss the work and its aims, and some of the key recommendations to ensure a safe and practical working environment in such settings.
A guiding principle for decontamination is that of standard precautions: any patient must be considered a potential infection risk, and each endoscope and device must be reprocessed with the same rigour following every endoscopic procedure. (BSG Guidelines for decontamination of equipment for gastrointestinal endoscopy). Decontamination involves a combination of processes, including cleaning and disinfection, and/or sterilisation, used to render a reusable item safe for further use. To maintain effective decontamination requires a multidisciplinary approach to the prevention and control of infection, including: n Adhering to standards, policies, procedures, protocols, and guidelines.
n Maintaining a controlled environment designed for the decontamination procedures undertaken.
n Investigation of incidents. n Staff education and training. n Validation, maintenance, and periodic testing, of decontamination equipment.
n Review, audit, and development of decontamination processes to ensure optimal levels of decontamination.
Segregated ‘clean’ and ‘dirty’ areas The built environment where decontamination processes are carried out is critical to the effectiveness of the outcome. Where possible, all activities should take place in segregated ‘clean’ and ‘dirty’ areas for the procedures carried out. The environmental conditions must be controlled to prevent adventitious contamination (both microbial and particulate contamination); such recontamination may arise from several sources, including the process, the environment, materials, and personnel. All built environments should comply with health and safety requirements for staff working with harmful chemicals, in accordance with the Control of Substances Hazardous to Health 2002 (COSHH) regulations.
Background This 2021 revision builds on the previous working party document (2016) to provide updated information on the safety and environmental requirements for endoscopy decontamination facilities.1 Endoscopy decontamination facilities are being centralised, with pass-through
endoscope-washer disinfectors (EWDs) being used to create the ‘dirty’ to ‘clean’ workflow path. Currently there is limited specific guidance on the air quality and ventilation for ‘cleanroom’ facilities in endoscopy decontamination suites. HTM 01-06 states that the principles of HBN 13 should be considered for new-build such facilities.2–4 The CSC re-formed a working party
to produce guidance on the principles for air quality safety considerations in refurbishments and new-builds for endoscope decontamination, and has considered that not all departments are a two-room design (recommended for new facilities), as space and the number of procedures carried out may only allow for a single room facility. The technical working party is a group of multidisciplinary members that represent various professional bodies (see text box, page 38).
Exclusions n The document excludes the processing of endoscopes that are being wrapped and subsequently sterilised, as this will come under the remit of HBN 13, SHPN 13 Part 1, HTM 01-06, Northern Ireland Amendment, and WHTM 01-06/ SHTM 01-06.2-5
n The document does not prescribe infection control practice and protocols for procedures when handling endoscopes, or the detailed design of decontamination facilities.
Basic principles Endoscopy decontamination and storage facilities are workplaces, and it is a legal requirement under the Building Regulations that they be ventilated.6,7
This An external duct from an endoscope washer-disinfector. 32 Health Estate Journal June 2022
document will set out how: 1) To meet this legal requirement. 2) To maintain a comfortable working environment. 3) To remove airborne hazards (biological and chemical) arising from the decontamination process.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76
